Intestinal permeability – a new target for disease prevention and therapy

By S. Bischoff, G. Barbara, W. Buurman, T. Ockhuizen, J. Schulzke, M. Serino, Herbert Tilg, A. Watson, J. Wells. BMC Gastroenterology, 2014

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Data are accumulating that emphasize the important role of the intestinal barrier and intestinal permeability for health and disease. However, these terms are poorly defined, their assessment is a matter of debate, and their clinical significance is not clearly established. In the present review, current knowledge on mucosal barrier and its role in disease prevention and therapy is summarized. First, the relevant terms ‘intestinal barrier’ and ‘intestinal permeability’ are defined. Secondly, the key element of the intestinal barrier affecting permeability are described. This barrier represents a huge mucosal surface, where billions of bacteria face the largest immune system of our body. On the one hand, an intact intestinal barrier protects the human organism against invasion of microorganisms and toxins, on the other hand, this barrier must be open to absorb essential fluids and nutrients. Such opposing goals are achieved by a complex anatomical and functional structure the intestinal barrier consists of, the functional status of which is described by ‘intestinal permeability’. Third, the regulation of intestinal permeability by diet and bacteria is depicted. In particular, potential barrier disruptors such as hypoperfusion of the gut, infections and toxins, but also selected over-dosed nutrients, drugs, and other lifestyle factors have to be considered. In the fourth part, the means to assess intestinal permeability are presented and critically discussed. The means vary enormously and probably assess different functional components of the barrier. The barrier assessments are further hindered by the natural variability of this functional entity depending on species and genes as well as on diet and other environmental factors. In the final part, we discuss selected diseases associated with increased intestinal permeability such as critically illness, inflammatory bowel diseases, celiac disease, food allergy, irritable bowel syndrome, and – more recently recognized – obesity and metabolic diseases. All these diseases are characterized by inflammation that might be triggered by the translocation of luminal components into the host. In summary, intestinal permeability, which is a feature of intestinal barrier function, is increasingly recognized as being of relevance for health and disease, and therefore, this topic warrants more attention.

Subfields: Gastroenterology, Molecular Biology, Physiology

View Paper: https://www.semanticscholar.org/paper/f7b6d703f104dfbcb50b22bb0167bf1fe225ae92

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Citations in the corpus

Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut (2015, background): “Both the probes are equally affected by gastrointestinal dilution, motility, bacterial degradation, and renal function; thus, the ratio allows for correcting possible confounding factors [9, 82].”
Brain-Gut-Microbiota Axis in Alzheimer’s Disease (2019, background): “coli Nissle, and Bifidobacterium infantis enhance intestinal barrier increasing expression of proteins forming tight junctions.(52) Other bacterial products, exotoxins, disrupt epithelial cell integrity.”
The intestinal barrier: a fundamental role in health and disease (2017, background): “More detailed analyses of specific changes that may affect the function of the intestinal barrier can be achieved using molecular and histological approaches on intestinal tissue sections [15].”
Human Intestinal Barrier Function in Health and Disease (2016, background): “TJs are protein complexes that connect adjacent epithelial cells near their apical pole.(1) The core TJ complex is composed of transmembrane proteins, including”
Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review (2023, background): “The TJs are composed of three groups of transmembrane proteins which interact with cytoskeletal actomyosin ring: claudin family, Marvel domain-containing proteins, and immunoglobulin superfamily [2].”